[Testosterone replacement therapy improves metabolic indexes of the patients with hypogonadism: A meta-analysis]

To systematically evaluate the effect of testosterone replacement therapy (TRT) on metabolic indexes in patients with hypogonadism.

We searched the databases of CNKI, CBM, Wanfang Data, VIP, PubMed, Medline, Embase and Cochrane Library from the establishment to May 2021 for clinical randomized controlled trials (RCT) on the improvement of metabolic indexes of the patients with hypogonadism treated by TRT. According to the inclusion and excretion criteria, we screened the literature, extracted the data and evaluated the quality of the included RCTs, followed by statistical analysis with the STATA15.1 software.

Totally 19 RCTs with 1 553 cases were included. Compared with placebo, TRT effectively reduced the levels of fasting plasma glucose (FPG) and fasting insulin (FINS), improved Homeostatic Model Assessment-insulin resistance (HOMA-IR), decreased total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), increased the body mass index (BMI), lowered the waist circumference (WC), but elevated the systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the patients. No statistically significant differences were observed in the improvement of glycosylated hemoglobin (HbA1c) and triglyceride (TG) between the TRT-treated patients and placebo controls. The results of Egger's and Begg's tests showed no significant publication bias among the studies.

TRT can significantly improve metabolic indexes in patients with hypogonadism, though further studies are needed to confirm its long-term efficacy and safety in patients with metabolic disorders.